Mr Mark Anthony Doublet, RD, CDE in Port Jefferson, NY - Medicare Dietitian, Registered Provider

Mr Mark Anthony Doublet, RD, CDE is a medicare enrolled "Dietitian, Registered" provider in Port Jefferson, New York. His current practice location is 75 N Country Rd, Port Jefferson, New York. You can reach out to his office (for appointments etc.) via phone at (631) 686-2505.

Mr Mark Anthony Doublet is licensed to practice in New York (license number 1005065) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1659814077.

Contact Information

	Mr Mark Anthony Doublet, RD, CDE
	75 N Country Rd, Port Jefferson, NY 11777-2119
	(631) 686-2505
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Mark Anthony Doublet
Gender	Male
Speciality	Dietitian, Registered
Location	75 N Country Rd, Port Jefferson, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659814077
Provider Enumeration Date: 12/03/2016
Last Update Date: 12/03/2016

Medicare PECOS Information:

PECOS PAC ID: 3072898402
Enrollment ID: I20170327000018

Medical Identifiers

Medical identifiers for Mr Mark Anthony Doublet such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659814077	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	1005065 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Mark Anthony Doublet allows following entities to bill medicare on his behalf.

Provider Name	Optum Medical Care Pc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1982643003 PECOS PAC ID: 9931013240 Enrollment ID: O20031119000321

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark Anthony Doublet is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Mark Anthony Doublet, RD, CDE 215 Westview Ave, Deer Park, NY 11729-6404 Ph: (516) 523-4413	Mr Mark Anthony Doublet, RD, CDE 75 N Country Rd, Port Jefferson, NY 11777-2119 Ph: (631) 686-2505

Reviews and Comments

Dietitian, Registered in Port Jefferson, NY

Denine Cannistra, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 200 Belle Terre Rd, Port Jefferson, NY 11777 Phone: 631-474-6300 Fax: 631-474-6161
Kathryn Shouler, R.D.N Dietitian Medicare: Not Enrolled in Medicare Practice Location: 125 Oakland Ave Ste 203, Port Jefferson, NY 11777 Phone: 631-686-2551 Fax: 631-686-2552
Jaime Ann Kohlmann, RD, CDE, CDN Dietitian Medicare: Medicare Enrolled Practice Location: 125 Oakland Ave, Port Jefferson, NY 11777 Phone: 631-978-7590
Mrs. Darlene Renee Petroccione, RD, CDN Dietitian Medicare: Accepting Medicare Assignments Practice Location: 640 Belle Terre Rd, Building E, Port Jefferson, NY 11777 Phone: 631-987-4006 Fax: 631-828-1138
Rachel Cipriano, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 24 Winston Dr N, Port Jefferson, NY 11777 Phone: 631-512-2979
Medical Weight Management Dietitian Medicare: Not Enrolled in Medicare Practice Location: 625 Belle Terre Rd, Suite 203, Port Jefferson, NY 11777 Phone: 631-686-7897 Fax: 631-686-2503
Katie Obojkovits, MS, RDN, CDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 625 Belle Terre Rd Ste 203, Port Jefferson, NY 11777 Phone: 631-686-7680

Mr Mark Anthony Doublet, RD, CDE - Medicare Dietitian in Port Jefferson, NY